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身体活动不足是否会导致老年2型糖尿病患者认知功能下降:倾向评分匹配分析

Does low physical activity cause cognitive decline in elderly type 2 diabetes patients: A propensity score matching analysis.

作者信息

Ma Yi-Xin, Li Jing, Si Si-Cong, Zhao Huan, Liu Jia, Lv Long-Feng, Yang Kai, Yang Wei

机构信息

Department of Geriatrics, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing 100053, China.

出版信息

World J Diabetes. 2025 Jun 15;16(6):105496. doi: 10.4239/wjd.v16.i6.105496.

Abstract

BACKGROUND

The relationship between low physical activity and cognitive impairment in type 2 diabetes mellitus (T2DM) patients remains unclear.

AIM

To explore this association and identify risk factors for cognitive impairment in elderly T2DM patients.

METHODS

A retrospective analysis was conducted on 245 elderly T2DM patients treated at Xuanwu Hospital, Beijing, in 2023. Patients were categorized into low physical activity ( = 126) and non-low physical activity ( = 119) groups. After propensity score matching (PSM) of 100 pairs, univariate and binary logistic regression analyses identified risk factors for cognitive impairment. A predictive model was constructed and evaluated using receiver operating characteristic curve analysis.

RESULTS

Before PSM, the percentage of cognitive impairment was higher in the low physical activity group ( < 0.05), but after PSM, this difference was not significant ( > 0.05). Additionally, on regression analyses after PSM, age, occupation type, history of stroke, malnutrition, and frailty remained independent factors associated with cognitive impairment, while low physical activity did not. The constructed risk prediction model for cognitive impairment in elderly T2DM patients exhibited an area under the curve of 0.77.

CONCLUSION

Low physical activity was not associated with cognitive impairment in our study population. Some results differed before and after PSM analysis, indicating that PSM supports objective assessment of risk factors by controlling for selection bias and confounding factors related to population characteristics. The constructed cognitive risk model provides insight for the development of a clinical tool for early prevention of cognitive impairment in elderly T2DM patients.

摘要

背景

2型糖尿病(T2DM)患者身体活动不足与认知障碍之间的关系尚不清楚。

目的

探讨老年T2DM患者身体活动不足与认知障碍之间的关联,并确定认知障碍的危险因素。

方法

对2023年在北京宣武医院接受治疗的245例老年T2DM患者进行回顾性分析。将患者分为身体活动不足组(=126)和非身体活动不足组(=119)。在进行100对倾向评分匹配(PSM)后,采用单因素和二元逻辑回归分析确定认知障碍的危险因素。构建预测模型并使用受试者工作特征曲线分析进行评估。

结果

在PSM之前,身体活动不足组的认知障碍百分比更高(<0.05),但在PSM之后,这种差异不显著(>0.05)。此外,在PSM后的回归分析中,年龄、职业类型、中风病史、营养不良和虚弱仍然是与认知障碍相关的独立因素,而身体活动不足则不是。构建的老年T2DM患者认知障碍风险预测模型的曲线下面积为0.77。

结论

在我们的研究人群中,身体活动不足与认知障碍无关。PSM分析前后的一些结果有所不同,这表明PSM通过控制与人群特征相关的选择偏倚和混杂因素,支持对危险因素进行客观评估。构建的认知风险模型为开发用于早期预防老年T2DM患者认知障碍的临床工具提供了思路。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23db/12179912/6850fa6396d8/wjd-16-6-105496-g001.jpg

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